Associazione Nazionale Medici Cardiologi Ospedalieri

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CONGRESS ABSTRACT

CONGRESS ABSTRACT

THE PROGNOSTIC VALUE OF NON-INVASIVE VENTILATION IN PATIENTS WITH ACUTE HEART FAILURE

Barnaba Ivano Bari (Ba) – Cardiologia, Università Degli Studi Di Bari “Aldo Moro” | Cinelli Assunta Altamura (Ba) – Pronto Soccorso, Ospedale “F. Perinei” | Iacoviello Massimo Foggia (Fg) – Cardiologia, Università Degli Studi Di Foggia | Citarelli Gaetano Bari (Ba) – Cardiologia, Ospeldale “San Paolo” | Ricci Gabriella Bari (Ba) – Cardiologia, Ospedale “San Paolo” | Campanella Cosimo Bari (Ba) – Cardiologia, Ospedale “San Paolo” | Bonfantino Vincenzo Massimo Bari (Ba) – Cardiologia, Ospedale “Di Venere” | Caldarola Pasquale Bari (Ba) – Cardiologia, Ospedale “San Paolo” | Ciccone Marco Matteo Bari (Ba) – Cardiologia, Università Degli Studi Di Bari “Aldo Moro” | Massari Francesco Altamura (Ba) – Cardiologia, Ospedale “F. Perinei” | Scicchitano Pietro Altamura (Ba) – Cardiologia, Ospedale “F. Perinei”

Objectives: Patients with acute heart failure (AHF) often receive initial non-invasive ventilation (NIV). This study aimed to evaluate the prognostic role of NIV in patients hospitalized for AHF. Methods: This was a retrospective cohort study. We enrolled patients admitted to our cardiac intensive care unit with a diagnosis of AHF. Anthropometric, clinical, pharmacological, and instrumental assessments were collected. Both in-hospital and 180-day post-discharge mortality were evaluated. Results: Among 200 patients (mean age 81 ± 9 years; 52% male), NIV was applied in 80 cases (40%). These patients had more severe NYHA functional class, a higher prevalence of de novo AHF, required higher diuretic doses, and had longer hospital stays. In multivariate analysis, NIV remained significantly associated with length of stay (LOS) (r = 0.26; p = 0.0004). In-hospital mortality was 5% overall and significantly higher in the NIV group compared to non-NIV patients (10% vs. 1.6%, p < 0.001). At 180 days, mortality was also significantly higher in the NIV group [hazard ratio (HR) 1.84; 95% confidence interval (CI): 1.18-2.85; p = 0.006]. After adjusting for age, BNP, CRP, arterial blood gas parameters, renal function, and LVEF, NIV remained an independent predictor of 180-day mortality (HR 1.61; 95% CI: 1.01-2.54; p = 0.04). Conclusions: Patients with AHF who required NIV exhibited more severe disease and longer hospital stays. NIV use was independently associated with both in-hospital and post-discharge mortality, suggesting its potential role as a prognostic marker in AHF.